Healthcare Provider Details

I. General information

NPI: 1497781710
Provider Name (Legal Business Name): COMMENCEMENT HEALTH CARE PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 MARTIN LUTHER KING JR WAY SUITE 400
TACOMA WA
98405-4250
US

IV. Provider business mailing address

314 MARTIN LUTHER KING JR WAY SUITE 400
TACOMA WA
98405-4250
US

V. Phone/Fax

Practice location:
  • Phone: 253-627-0666
  • Fax: 253-627-3159
Mailing address:
  • Phone: 253-627-0666
  • Fax: 253-627-3159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KAREN M NELSON
Title or Position: PRESIDENT
Credential: MD
Phone: 253-627-0666